Management Of Cardiac Patients Research Articles

Common Echocardiographic Diagnoses in Patients at Tertiary Care Center: An Observational Study

Introduction: Echocardiography is an indispensable tool for the diagnosis and management of cardiac patients. It is important to know the spectrum of cardiac abnormalities detected by echocardiography for the proper management of patients. The aim of this study was to evaluate the echocardiographic diagnosis of patients at a multispecialty tertiary care hospital and find out the prevalence of various cardiac diseases diagnosed via echocardiography.Methods: This was a retrospective cross sectional study carried out at the Echocardiography lab of National Academy of Health Sciences. Records of all patients who had done Echocardiography from February 2024 to April 2024 were analyzed. Ethical approval was obtained from Institutional Review Committee (Reference Number:1231/2080/81).Results: Out of 3593 cases, there were 1750 (48.71%) female and 1843 (51.29%) male. Normal echocardiographic study was seen in 1184 (32.95%). Mean age was 56.13±17.38 years. Left ventricle diastolic dysfunction was seen among 1428 (39.74%), followed by tricuspid regurgitation 1026 (28.55%) and pulmonary hypertension 497 (13.83%). Other findings were, left ventricular hypertrophy 204 (5.67%), Left ventricular systolic dysfunction 165 (4.59%), rheumatic heart disease 102 (2.83%) and, congenital heart disease was the lowest documented finding, seen in 30 (0.83%).Conclusions: Most common diseases diagnosed by echocardiography in our study were, diastolic dysfunction, tricuspid regurgitation and pulmonary hypertension.

Management of a Patient with Cardiovascular Disease Should Include Assessment of Primary and Secondary Immunodeficiencies: Part 1—Primary Immunodeficiencies

Background: Cardiovascular diseases are some of the most prevalent chronic diseases that generate not only high social but also economic costs. It is becoming increasingly crucial to take into account inborn errors of immunity (IEIs, formerly known as primary immunodeficiencies (PIDs)) and secondary immunodeficiencies (SIDs) in the diagnostic and therapeutic management of cardiac patients. The number of diseases classified as IEIs is on the rise, with a current total of 485. It is essential to pay attention not only to already confirmed conditions but also to symptoms suggestive of immunodeficiencies. Objectives: The aim of this article is to present IEIs with cardiovascular symptoms that may cause or exacerbate cardiovascular disease, as well as diagnostic and therapeutic procedures. Results: It is becoming increasingly evident that immunodeficiencies can be responsible for certain cardiovascular conditions, their hastened progression, and difficulties in their control. Conclusions: Early detection of deficiencies improves not only the quality and longevity of patients, but also allows for better control of cardiovascular diseases and even prevention of their occurrence.

Predictors of spontaneous intracerebral hemorrhage mortality: a community-based study in Brno, Czech Republic.

Intracerebral hemorrhage (ICH) is a serious medical condition with high mortality. However, factors leading to long-term mortality after ICH are largely unclear. The aim of this community-based study is to assess predictors of long-term mortality after spontaneous ICH. We identified all patients admitted with spontaneous ICH to hospitals with a certified stroke unit in Brno, the second largest city in the Czech Republic (CR), in 2011, the year of the Czech Population and Housing Census. We reviewed their medical records for risk factors, radiographic parameters, and measures of post-stroke neurological deficit [National Institutes of Health Stroke Scale (NIHSS)]. Using the dates of death from the Czech National Mortality Register, we calculated mortality at 30days, six months, one year, and three years after the ICH. Multivariate analysis with forward stepwise logistic regression was performed to determine independent predictors of mortality (p < 0.05). In 2011, 1086 patients with stroke were admitted to the four stroke-certified hospitals in Brno, CR. Of these, 134 had spontaneous ICH, with complete data available in 93 of them entering the final analysis. The mortality at 30days, 6months, 1year, and 3years post-ICH was 34%, 47%, 51%, and 63%, respectively. The mortality was highest in the first few days post-event, with 50% of patients dying in 255days and average survival being 884 ± 90days. Both NIHSS and modified ICH (MICH) score showed to be strong and reliable predictors of short- as well as long-term mortality; the risk of death post-ICH increased with older age and size of ICH. Other risk factors contributing to higher, primarily shorter-term mortality included history of cardiac failure, myocardial infarction, or atrial fibrillation. In our community-based study, we found that severity of neurological deficit at admission (NIHSS), combined with age and size of ICH, well predicted short- as well as long-term mortality after spontaneous ICH. A history of cardiac failure, myocardial infarction, or atrial fibrillation at presentation were also predictors of mortality, underscoring the need for optimal cardiac management in patients with ICH.

The Echo Report Understood: Improving Education in Echocardiography for Junior Doctors.

With echocardiography standing as the most widely used cardiac imaging modality, echocardiography report interpretation is a core responsibility of junior doctors. The literature, however, reveals a deficit in echocardiography education. The implications of this for patient care should not be ignored. To address this need, a hybrid teaching session was developed for junior (intern and resident grade) doctors, with the aim to increase understanding of echocardiography and increase confidence in report interpretation. Pre- and post-session data were analysed. Results revealed that the vast majority of respondents received less than an hour of echocardiography teaching at medical school, with over two-thirds receiving less than an hour in the postgraduate setting. A total of 80% of doctors interpreted echocardiography reports weekly, with almost all doctors perceiving this skill as important. Despite this, an overwhelming majority of doctors did not feel confident interpreting reports.The educational intervention achieved significant increases in perceived understanding of echocardiography and confidence with report interpretation. Participants were better able to identify cardiac pathology and understand report terminology. This intervention has the scope to improve patient safety through better management of cardiac patients and recognition of pathology from echocardiography. This work also identifies a need for more echocardiography education, having uncovered a concerning lack of confidence amongst junior doctors and an appetite for further teaching on this important topic.

EGFR-TKIs - induced cardiotoxicity in NSCLC: incidence, evaluation, and monitoring.

The advent of targeted drug therapy has greatly changed the treatment landscape of advanced non-small cell lung cancer(NSCLC), but the cardioxic side effects of targeted drug anti-cancer therapy seriously affect the prognosis of NSCLC, and it has become the second leading cause of death in cancer patients. Therefore, early identification of the cardiotoxic side effects of targeted drugs is crucial for the prevention and treatment of cardiovascular diseases. The cardiotoxic side effects that may be caused by novel targeted drugs epidermal growth factor receptor inhibitors, including thromboembolic events, heart failure, cardiomyopathy, arrhythmia and hypertension, are discussed, and the mechanisms of their respective adverse cardiovascular reactions are summarized, to provide useful recommendations for cardiac management of patients with advanced lung cancer to maximize treatment outcomes for lung cancer survivors. Clinicians need to balance the risk-benefit ratio between targeted therapy for malignant tumors and drug-induced cardiotoxicity, and evaluate and monitor TKIs-induced cardiotoxicity through electrocardiogram, cardiac imaging, biomarkers, etc., so as to remove the susceptibility risk factors as soon as possible and provide a reference for the clinical use of such drugs in the treatment of malignant tumors.

The impact of telemedicine on cardiac patient outcomes: A study in Saudi Arabian hospitals

&lt;sec&gt;&lt;title&gt;Introduction&lt;/title&gt;&lt;p&gt;Telemedicine has been increasingly integrated into cardiac care, thus offering remote monitoring and consultation for patients with cardiovascular diseases. It promises to improve patient outcomes, especially in heart failure management, by enabling continuous monitoring of vital signs and facilitating remote patient-provider interactions. This technology has gained particular significance amidst the COVID-19 pandemic, thereby offering a safer alternative to in-person visits. This study assesses the effectiveness of telemedicine in the management of cardiac patients in Saudi Arabia, and reflects on its benefits, challenges, and overall impact on patient outcomes.&lt;/p&gt;&lt;/sec&gt;&lt;sec&gt;&lt;title&gt;Methods&lt;/title&gt;&lt;p&gt;A retrospective cohort study was conducted to analyze patient records from Saudi healthcare facilities and compare health indicators before and after telemedicine implementation. The study involved cardiac patients who received telemedicine consultations and a control group who received traditional care. Statistical analyses, including the chi-square test, t-test, and ANOVA, were performed to identify differences between the groups while controlling for confounders.&lt;/p&gt;&lt;/sec&gt;&lt;sec&gt;&lt;title&gt;Results&lt;/title&gt;&lt;p&gt;There were no statistically significant differences between the telemedicine and control groups in terms of blood pressure (P = 0.72), heart rate (P = 0.65), readmission rate (P = 0.54), and medication adherence (P = 0.48). The patient satisfaction was slightly higher in the telemedicine group, although the difference was not statistically significant (mean satisfaction score of 3.01 vs. 2.83, P = 0.41).&lt;/p&gt;&lt;/sec&gt;&lt;sec&gt;&lt;title&gt;Conclusions&lt;/title&gt;&lt;p&gt;The introduction of telemedicine did not significantly alter the cardiac patient outcomes compared with traditional in-person care in Saudi Arabia. Although telemedicine offers a promising alternative for patient management, its effectiveness may vary based on the individual patient's needs and specific health indicators. Further research is necessary to explore its full potential and to optimize its application in cardiac care.&lt;/p&gt;&lt;/sec&gt;

The efficacy of phase I cardiac rehabilitation training based on augmented reality on the self-efficacy of patients undergoing coronary artery bypass graft surgery: A randomized clinical trial

BackgroundOpen-heart surgery is considered one of the primary treatments for severe coronary artery stenosis, but it comes with its own set of complications. However, these complications can be reduced through the implementation of proper cardiac rehabilitation during phase I. This study aimed to examine the impact of phase I cardiac rehabilitation training, using augmented reality, on the self-efficacy of cardiac management in patients undergoing coronary artery bypass grafting.MethodologyThis randomized clinical trial study involved 60 patients who were admitted to the Cardiac Surgery Intensive Care Unit at Ghaem Hospital in Mashhad. The software used in this study consisted of various videos and educational images demonstrating physical exercises for cardiac rehabilitation. The software was developed to train the patients in the intervention group on the rehabilitation program, starting from their admission to the Intensive Care Unit until their discharge from the hospital. The collected data were analyzed using statistical tests such as independent t-test, Mann-Whitney test, paired t-test, chi-square test, as well as descriptive indicators. Cohen’s d was also used to evaluate the magnitude of the effect size.ResultsThe findings of this study revealed that the total mean score for cardiovascular management self-efficacy significantly increased during the transfer to the Intensive Care Unit and at the time of discharge. Notably, the increase observed in the intervention group was significantly greater than that of the control group (P < 0.001).ConclusionThe results of this study indicated that implementing early rehabilitation programs, using innovative educational technology like augmented reality, enhanced the self-efficacy of patients undergoing coronary artery bypass grafting. These findings suggest that such programs can be effectively employed as educational tools throughout different stages of cardiac rehabilitation.Trial RegistrationThis study was registered in the Iranian Registry of Clinical Trials (no. IRCT20200203046361N1) on 16/02/2020.

Evaluation of the Effectiveness of Promoting Pain Self-Management on Functional Self-Efficacy of Nursing Students in the Care of Patients

Introduction: Pain management training can change the judgment and confidence of nursing students about their talents and abilities in caring for heart surgery patients. Aim of this study was determining the effectiveness of promoting pain self-management on functional self-efficacy of nursing students in the care of coronary artery bypass patients. Methods: This interventional study was conducted on all final year nursing students of Urmia Azad University. Sampling by census in the period from June to December 2022 and all final year nursing students were randomly divided into intervention and control groups. At the beginning of the study, students in both groups completed the demographic information questionnaire and clinical performance self-efficacy questionnaire. The validity of the questionnaire has been confirmed through its content, form and final validity with Cronbach's alpha coefficient of 0.96. The students of the intervention group received the necessary training as a group for 6 sessions of 45 minutes and twice a week with an interval of two days, and the control group received the usual training according to the curriculum and educational topics. At the end of the intervention, students in both groups completed the clinical functional self-efficacy questionnaire again. Statistical analysis of data has been done by paired group t test and independent group t test through SPSS. Results: The results showed that there was no significant difference in the average clinical self-efficacy scores of nursing students between the intervention and control groups before the implementation of pain management training (p=0.53 and t=11.02), while the average The overall clinical performance self-efficacy scores were significantly different between the intervention and control groups after the implementation of pain management training (p=0.003 and t=3.36). Conclusion:. According to the findings, the pain management training program is effective on the clinical performance self-efficacy of nursing students. Therefore, pain management training can help in the development of nursing students' abilities in academic environments and improve the beliefs of nursing students in relation to their ability to perform their specialized duties in the management of cardiac patients after surgery.

Management of cardiac patient during the month of ramadan

Management of cardiac patient during the month of ramadan

Early Postoperative Volume Overload is a Predictor of 1-Year Post-Transplant Mortality in Pediatric Heart Transplant Recipients

Fluid restriction and diuretic management are mainstays in the postoperative management of cardiac patients, at risk of volume overload and its deleterious effects on primary cardiac function and multi-organ systems. The importance of fluid homeostasis is further emphasized among orthotopic heart transplant recipients (OHT). We sought to investigate the relationship between postoperative volume overload, mortality, and allograft dysfunction among pediatric OHT recipients within 1-year of transplantation. This is a retrospective cohort study from a single pediatric OHT center. Children under 21 years undergoing cardiac transplantation between 2010 and 2018 were included. Cumulative fluid overload (cFO) was assessed as percent fluid accumulation adjusted for preoperative body weight. Greater than 10% cFO defined those with postoperative cFO and a comparison of postoperative cFO vs. no postoperative cFO (< 5%) is reported. 102 pediatric OHT recipients were included. Early cFO at 72 h post-OHT occurred in 14% and overall cFO at 1-week post-OHT occurred in 23% of patients. Risk factors for cFO included younger age, lower weight, and postoperative ECMO. Early cFO was associated with postoperative mortality at 1-year, OR 8.6 (95% CI 1.4, 51.6), p = 0.04, independent of age and weight. There was no significant relationship between cFO and allograft dysfunction, measured by rates of clinical rejection and cardiopulmonary filling pressures within 1-year of transplant. Early postoperative volume overload is prevalent and associated with increased risk of death at 1-year among pediatric OHT recipients. It may be an important postoperative marker of transplant survival, and this relationship warrants further clinical investigation.

Digital Form for Assessing Dentistry Undergraduates Regarding Periodontal Disease Associated with Cardiovascular Diseases

Background: Throughout recent years, periodontal disease (PD) has been linked to innumerable medical systemic conditions, such as cardiovascular disease (CVD). This association could negatively impact oral health, so the knowledge of dentists who have graduated must follow modern dentistry in order to promote oral health, mainly in systemically compromised patients. Therefore, the present study aimed to determine and evaluate the knowledge level of dentistry undergraduate students (DUS) regarding the correct periodontal treatment and management of cardiac patients with PD. Methods: This cross-sectional and populational-based study was conducted between March and June 2022 in northern Brazil. A total of 153 DUS received an anonymous digital form (Google Forms Platform) using a non-probabilistic "snowball" sampling technique. The digital form was composed of four blocks of dichotomous and multiple-choice questions. After signing the informed consent term, DUS were divided into three groups according to their period/semester in dentistry graduation during the study time (G1: 1st period/semester; G2: 5th period/semester and G3: 10th period/semester). A total of 25 questions referring to demographic, educational and knowledge data about the dental and periodontal care of cardiac patients with PD were asked, and all data were presented as descriptive percentages and then analyzed using the Kappa test. Results: From a total of 153 (100%) DUS, the sample was mostly composed of 104 (68%) female participants, with an average age of 21.1 years. Regarding basic knowledge, the majority of answers were no, with G1 being higher than G2 and G3. Regarding clinical questions, 1247 (58.3%) answers were no. Additionally, regarding fundamental clinical questions 1, 2, 3, 7, 9, 11, 13 and 14, the majority of G1, G2 and G3 answered no, demonstrating a major lack of knowledge. Conclusions: In our study, DUS demonstrated a low knowledge level of the dental and periodontal care of cardiac patients with PD and its bi-directional link. Thus, according to our results, an improvement in dentistry educational programs regarding periodontal medicine must be implemented.

The Effect of Cell Salvage on Bleeding and Transfusion Needs in Cardiac Surgery.

Introduction Cell salvaging is well established in the blood management of cardiac patients, but there remain some concerns about its effects on perioperative bleeding and transfusion variables. This randomized controlled study investigated the potential effects of the centrifuged end-product on bleeding, transfusion rates, and other transfusion-related variables in adult cardiac surgery patients submitted to extracorporeal circulation. Materials and Methods Patients were randomly chosen to receive (cell-salvage group, 99 patients) or not to receive (control group, 110 patients) the centrifuged product of a cell salvage apparatus. Bleeding and transfusion rates according to the universal definition of perioperative bleeding (UDPB) classification, postoperative hemoglobin, coagulation, and oxygenation indices were recorded and compared between the groups. Results Both groups had almost identical bleeding and transfusion rates (median value: 2 units of red blood cells (RBC) and no units of fresh frozen plasma (FFP) and platelets (PLT) for both groups, p > 0.05). Patients in the cell-salvage group presented slightly higher hemoglobin concentrations (10.6 ± 1.1 vs. 10.1 ± 1.7 g/dL, p < 0.05, respectively) and a tendency towards better oxygenation indices (PaO2/FiO2: 241 ± 94 vs. 207 ± 84, p=0.013) in the postoperative period albeit with a tendency for prolongation of prothrombin time (INR: 1.31 ± 0.18 vs. 1.26 ± 0.12, p=0.008). Conclusion Within the study's constraints, the perioperative use of the cell salvage concentrate does not seem to affect bleeding or transfusion variables, although it could probably ameliorate postoperative oxygenation in adult cardiac surgery patients. A tendency to promote coagulation disturbances was detected.

An artificial intelligence model to predict 12-month mortality among patients with myocardial infarction

Abstract Funding Acknowledgements Type of funding sources: None. Background Ischemic heart disease and acute myocardial infarction (AMI) are the number one causes of death and disability, affecting around 126 million individuals worldwide [1]. About 30% of all cases of AMI lead to death. According to different sources, 8-20% of people with AMI die within 1 year of the event, and every second patient is rehospitalized [1-2]. Thus, it is necessary to assess the risk and to predict the outcomes during the first admission to the hospital, in order to guide the management and treatment after AMI [2]. Conventional risk rating scales and methods have a lot of drawbacks, so novel approaches such as artificial intelligence (AI) and deep learning (DL) methods have the potential to provide an accurate risk assessment and share decision-making in patients who experienced AMI [3-4]. Purpose To develop and validate a deep-learning-based risk stratification model to predict the 12-months mortality in patients with AMI. Methods A cohort of 250 AMI patients with Killip class I-IV was enrolled in the study. The data was collected on the admission day and a year after the event and included anamnesis as well as the results of the physical and laboratory-instrumental examination (72 values). All patients were randomly divided into 2 groups: the derivation cohort, which consisted of 215 individuals, and the validation cohort consisted of 35 patients. Our model was created using the Python programming language in GoogleColab and it is a convolutional neural network (CNN) with 1 input layer, 4 hidden layers, and 1 output layer consisting of neurons with a sigmoid activation function (Fig. 1). We used MaxAbsScaler for data normalization and Adam for optimization. Also, we calculated the GRACE risk score and compared the performance of the models only for the validation cohort that was not used for the model development. Results We developed our DL-based model using the derivation data during the 30 cycles of work, receiving the maximum value of training accuracy of 96.7%. The mortality risk, calculated by our model for the validation group was compared with real 12-months mortality, and the CNN "lied" only 2 times (Table 1). The test of the validation cohort showed such results of our DL-based model: 94% - accuracy, 71% - sensitivity, 100% - specificity, 100% - positive, and 93% - negative prognostic value. These results significantly outperformed the GRACE scale, which showed 63%, 71%, 54%, 26%, and 94% respectively. Conclusions In summary, we develop and validate a DL-based risk stratification model to predict the 12-months mortality in patients with AMI. The accuracy of the created model is significantly higher than conventional risk scales (GRACE score). Thus, it is proved that algorithms based on deep learning may be more effective to predict mortality and guide the management of cardiac patients.

A Heart Team Approach to Assessing Frailty in the Cardiac Catheterization Laboratory

IntroductionFrailty is a well-documented risk factor for increased morbidity and mortality among patients undergoing percutaneous coronary intervention (PCI). There remains a lack of knowledge regarding the impact of patient frailty in cardiac patient management and outcomes. Thus, this study examined whether the Heart Team, without using frailty assessments, made decisions regarding coronary interventions [medical management (MM) vs. PCI vs. coronary artery bypass grafting (CABG)] that aligned with formally quantified frailty status. Material and methodsThis cross-sectional quality-improvement (QI) study was performed at a single, large, urban Veterans Affairs Hospital. From September 2019 to November 2020, heart team nurses approached patients prior to coronary angiograms and assessed for frailty using the Risk Analysis Index Questionnaire (RAIC). Interventional cardiologists were blinded to the results. This study's independent variable was RAI-C score. The outcome variables were “intervention performed” (MM, PCI, or CABG) and presence of a “reduced invasiveness intervention” (RI). ResultsNinety-five of the 182 participants had obstructive coronary artery disease. Among them, there were 69 PCIs, 10 CABGs, and 16 MMs. 26 received RIs. The primary outcomes demonstrated that frailty score was positively associated with receiving RI [adjusted OR = 1.13, 95% CI = 1.02–1.24, p = 0.02] and MM [adjusted OR = 1.13, CI = 1.02–1.25, p = 0.02], and negatively associated with receiving PCI [adjusted OR = 0.94, CI = 0.88–0.998, p = 0.04]. There was no significant association between frailty and the likelihood of undergoing CABG [AOR = 0.95, CI = 0.81–1.10, p = 0.47]. ConclusionThis study demonstrated that the Heart Team and patients at baseline reduced high-risk interventions in frailer patients. A Heart Team, shared-decision-making model utilizing the RAI-C was found to be efficient and effective at measuring frailty in coronary angiogram patients and should be considered for use in the clinical setting.

Efficient Pix2Vox++ for 3D Cardiac Reconstruction from 2D echo views.

Accurate geometric quantification of the human heart is a key step in the diagnosis of numerous cardiac diseases, and in the management of cardiac patients. Ultrasound imaging is the primary modality for cardiac imaging, however acquisition requires high operator skill, and its interpretation and analysis is difficult due to artifacts. Reconstructing cardiac anatomy in 3D can enable discovery of new biomarkers and make imaging less dependent on operator expertise, however most ultrasound systems only have 2D imaging capabilities. We propose both a simple alteration to the Pix2Vox++ networks for a sizeable reduction in memory usage and computational complexity, and a pipeline to perform reconstruction of 3D anatomy from 2D standard cardiac views, effectively enabling 3D anatomical reconstruction from limited 2D data. We evaluate our pipeline using synthetically generated data achieving accurate 3D whole-heart reconstructions (peak intersection over union score > 0.88) from just two standard anatomical 2D views of the heart. We also show preliminary results using real echo images.

From guidelines to clinical practice: current recommendations for the management of cardiac patients undergoing non-cardiac surgery

Non-cardiac surgeries account for nearly 85% of the to­tal 300 million surgeries that are performed annually world­wide, cardiovascular events representing the main source of perioperative morbidity and mortality. Considering that often patients suffering from cardiovascular (CV) di­sea­ses tend be clinically fragile, clear recommendations are needed to guide clinical decisions, in order to minimize their perioperative risk. The current ESC guideline main­tains some of the classic indications, emphasizing the im­por­tance of preoperative risk assessment and clinical exa­mi­na­tion of the patients suffering from a CV disease. It also introduces new concepts regarding the preoperative use of biomarkers, the perioperative thromboprophylaxis and the management of patients newly diagnosed with mur­murs, dyspnea, oedema or angina. Furthermore, other sec­tions, approaching complex clinical situations, as peri-ope­ra­tive management of antiplatelet and anti­coagulant the­ra­pies, have been revised, according to the latest studies. This review is meant to concisely present these new recom­men­da­tions, in a simplified and more accessible manner.

Coronavirus and cardiovascular manifestations- getting to the heart of the matter.

Coronavirus disease has unarguably been the largest pandemic of recent times. Over 150 million cases have occurred worldwide, and more than 3 million have succumbed to the disease. Cardiac manifestations can have varied presentations from an asymptomatic troponin rise to fulminant myocarditis. The pathogenesis of myocardial damage could be direct or indirect, including inflammation, coronary spasm, plaque rupture, and cytokine storm. Thromboembolism is also an important feature of cardiovascular affliction with both arterial and venous systems being affected. Hence, anticoagulation has also been a matter of debate. Fulminant myocarditis is the most severe form and can lead to circulatory shock with a high mortality. Management of cardiac patients with coronavirus disease 2019 (COVID-19) infection is not considerably different from non-COVID-19 cardiovascular disease, but interaction between cardiovascular drugs and anti-COVID-19 therapy requires careful attention. More recently, vaccines have emerged as a ray of hope for the disease. But simultaneously, there have been reports of thromboembolism following vaccination. In this review, we discuss the various aspects of coronavirus disease affecting of heart and its management.

Managing Cardiac Patients: Dentists’ Knowledge, Perceptions, and Practices

ObjectivesDental patients may require invasive treatment, and awareness of their medical conditions is essential for optimal care. We assessed the knowledge, perceptions, and attitudes of dentists practicing in Saudi Arabia (SA) and their associations with managing patients with common cardiac conditions. MethodsA national survey of knowledge and attitudes of practicing dentists towards patients with common cardiac conditions was conducted from May 2019 to July 2020 in SA. The survey comprised a newly developed, validated, electronic, self-administered English questionnaire. ResultsOverall, 282 dentists completed the survey, of whom 45.5% perceived cardiac patients as difficult to manage, while 64.5% stated that they refer these patients to cardiologists before dental intervention. Regarding knowledge about cardiac conditions, 72% achieved an overall knowledge score <55%; however, their infective endocarditis scores were better. Consultants and specialists (P < .001), those with a PhD/board certification (P = .013), dentists with prior education on cardiac patient management (P = .002), and those working with a cardiologist (P = .016) scored higher on knowledge. Conversely, private dentists (P = .003) and those referring patients to cardiologists before treatment (P = .003) scored lower. Dentists’ knowledge of cardiovascular diseases in women was low; only those who believed women experience a greater risk of cardiac complications achieved a higher score. Approximately 90.1% wished to receive education regarding cardiac patient management. ConclusionsKnowledge of cardiac patient management was suboptimal in this study. Dentists perceived cardiac patients as difficult to manage, but wished to learn more regarding optimal management. Thus, postgraduate education programmes that promote optimal dental management strategies for cardiac patients are necessary.

Pattern of Cardiac Diseases and Co-Existing Morbidities Among Newly Registered Cardiac Patients in an Adult Cardiac Referral Clinic of Hawassa University Comprehensive Specialized Hospital, Southern-Ethiopia.

BackgroundCurrently, cardiovascular diseases (CVDs) are rising in the world and require great concern because the consequences are not only morbidity and mortality, but also a high economic burden. However, the pattern of CVDs in Ethiopia is not well known. Therefore, this study aimed to describe CVD and co-existing morbidities among newly registered cardiac patients in Hawassa University Comprehensive Specialized Hospital.MethodsA retrospective cross-sectional study was conducted from January 1 to December 31, 2016 among newly registered cardiac patients in an adult cardiac referral clinic. Records and cardiac referral clinic logbooks were used to collect relevant information using structured checklists.ResultsOf the total 310 records of cardiac patients, 236 were explored and included in the study, while the records of 74 patients were absent in the cards room when tracing and/or incomplete to assess cardiac pattern. Rheumatic heart disease (RHD) was the leading cardiac problem and diagnosed in 70 (29.7%) cases followed by non-ischemic cardiomyopathy (55, 23.3%), ischemic heart disease (41, 17.4%), hypertensive heart disease (29, 12.3%), and cor pulmonale (14, 5.9%). The mean age of RHD patients was 28.7 (±13.1) years. Eighty-two (35%) females and 23 (19.8%) males had RHD, while 69 (29.2%) females and 23 (19.8%) males had non-ischemic cardiomyopathy. The overall rate of mitral stenosis, mitral regurgitation, and aortic regurgitation among patients with RHD were 39 (55.7%), 48 (68.6%), and 26 (37.1%), respectively. Moreover, the overall coexisted morbidity was 81 (34.3%), with a high rate of hypertension alone at 44 (18.6%) followed by hypertension with diabetes at 11 (4.7%).ConclusionThis study indicated that more than one-third of cardiac patients had at least one of the co-existing morbidities like hypertension, diabetes mellitus, asthma and other diseases. Therefore, careful diagnosis and management of cardiac patients plays an important role to minimize comorbidity-linked complications. Moreover, population-based studies are recommended for better representing and generalization.

Fluorodeoxyglucose Applications in Cardiac PET: Viability, Inflammation, Infection, and Beyond.

With its high temporal and spatial resolution and relatively low radiation exposure, positron emission tomography (PET) is increasingly being used in the management of cardiac patients, particularly those with inflammatory cardiomyopathies such as sarcoidosis. This review discusses the role of PET imaging in assessing myocardial viability, inflammatory cardiomyopathies, and endocarditis; describes the different protocols needed to acquire images for specific imaging tests; and examines imaging interpretation for each image dataset-including identification of the mismatch defect in viability imaging, which is associated with significant improvement in LV function after revascularization. We also review the role of fluorodeoxyglucose PET in cardiac sarcoidosis diagnosis, the complementary role of magnetic resonance imaging in inflammatory cardiomyopathy, and the emerging use of cardiac PET in prosthetic valve endocarditis.